Nosebleeds occur when a blood vessel in your nose bursts. Bloody noses are common. Around 60 percent of Americans will experience a nosebleed some time in their life. About 6 percent will require medical attention.

Although there are many reasons that your nose bleeds, the two most common causes are direct impact injury and the temperature and humidity of your environment.

  • Trauma. Fractures of the nose or the base of the skull can result in a bloody nose. If you’ve had a head injury that resulted in a bloody nose, see your doctor.
  • Dry air. A dry outside environment or heated indoor air can irritate and dry out nasal membranes. This can cause crusts that may itch and bleed when picked or scratched. If you catch a cold in the winter, the combination of repeated nose blowing with exposure to cold, dry air, sets the stage for nosebleeds.

Picking your nose

If you have allergies, such as hay fever or any other condition that causes your nose to itch, it can lead to conscious and unconscious nose picking.

Blowing your nose

If you blow your nose hard, the pressure can rupture superficial blood vessels.

Clotting disorders

Hereditary clotting disorders, such as hemophilia and hemorrhagic telangiectasia, may cause recurring nosebleeds.

Medications

If you’re taking medication that thins your blood or acts as an anticoagulant — such as aspirin, clopidogrel (Plavix), or warfarin (Coumadin) — nosebleeds can be more difficult to stop.

Topical medications and nasal sprays

Topical nasal medications, such as corticosteroids and antihistamines, can sometimes lead to nosebleeds. If you often use a nasal spray, the repeated irritation caused by the tip of the bottle could cause nosebleeds.

Dietary supplements

Certain dietary supplements can thin your blood and prolong bleeding, causing nosebleeds that are difficult to stop. These include:

Underlying conditions

If you have certain conditions such as kidney or liver disease, your blood’s ability to clot may be lower, making nosebleeds more difficult to stop.

Blood pressure

Conditions such as congestive heart failure or hypertension can make you more prone to nosebleeds.

Deformities

If you have a functional nasal deformity — congenital, cosmetic surgery, or injury related — it could lead to frequent nosebleeds.

Tumors

Tumors of the nose or sinuses — both malignant and nonmalignant — can lead to nosebleeds. This is more likely in older people and those who smoke.

Drug use

If you ingest cocaine or other drugs by snorting it into your nose, it can cause blood vessels in your nasal passages to rupture, leading to frequent nosebleeds.

Chemical irritants

If you’re exposed to chemical irritants — such as cigarette smoke, sulfuric acid, ammonia, gasoline — at work or elsewhere, it can lead to frequent and recurring nosebleeds.

While the majority of nosebleeds aren’t a cause for concern, some are. Get medical help right away if:

  • your nose doesn’t stop bleeding after 20 minutes
  • your nose is bleeding as the result of a head injury
  • your nose has an odd shape or feels broken after an injury

Schedule an appointment with your doctor if you experience frequent and repeated nosebleeds that aren’t caused by minor irritation. Frequent nosebleeds that occur more than once a week may be a sign of a problem that should be evaluated.

You can help cut down on the frequency of your nosebleeds and perhaps prevent them by taking some simple actions:

  • Avoid picking your nose and blow your nose gently.
  • If you smoke, try to quit and avoid areas with secondhand smoke.
  • Moisturize the inside of your nose with a nonprescription saline nasal spray.
  • Use a humidifier during the winter months.
  • Apply ointment, such as Bacitracin, A and D Ointment, Eucerin, Polysporin, or Vaseline, to the inside of each nostril at bedtime.
  • Wear your seatbelt to protect from facial trauma in the event of an accident.
  • Wear headgear that fits properly and protects your face when playing sports with a chance for face injury, such as karate, hockey, or lacrosse.
  • Avoid breathing in irritating chemicals by using properly rated protective equipment.

If you have frequent and recurring nosebleeds, talk to your doctor about possible causes and to discuss steps you can take to avoid them.

Your doctor may refer you to an otolaryngologist — an ear, nose, and throat specialist, also called an ENT. If you’re on a blood thinner, they might recommend adjusting the dose.